Who gets it?
After temporal lobe epilepsy, frontal lobe epilepsy is the next most common type of epilepsy featuring partial seizures. Frontal lobe epilepsy may run in families. In one rare genetic disorder (called autosomal dominant frontal lobe epilepsy or ADFLE), several individuals in a family typically have seizures during sleep. Frontal lobe seizures can be caused by abnormal brain tissue, for example from a dysplasia (birth defect in the brain), abnormal blood vessel, old stroke or trauma, rarely tumors, scars from prior infections and several other causes. In about half of cases, no cause is determined.
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The frontal lobes are large and include many areas that do not have a precisely known function. Therefore, when a seizure begins in these areas, there may be no symptoms until it spreads to other areas or to most of the brain, causing a tonic-clonic seizure. When areas that control movement (called motor areas) are affected, abnormal movements occur on the opposite side of the body. Seizures beginning in motor areas can cause weakness or the inability to use certain muscles, such as the muscles that allow someone to speak. Twisting, turning, pedaling or grimacing movements are common with frontal lobe seizures.
Sometimes a person remains fully aware during a frontal lobe seizure while having wild movements of the arms and legs. Because of their strange nature, frontal lobe seizures can be misdiagnosed as nonepileptic seizures.
The features of seizures may suggest whether they begin in the frontal or temporal lobes. Yet, the only way to be certain about where they start is to obtain an EEG recording during a seizure. Occasionally, an EEG recorded from the scalp may be not give enough information, even during a frontal lobe seizure if the seizure activity remains deep in the brain.
Complex partial seizures (during which the person is not aware) also may begin in the frontal lobes. Complex partial seizures beginning in the frontal lobe tend to be shorter (usually lasting less than 1 minute) than ones that start in the temporal lobe. They also are less likely to be followed by confusion or tiredness, more often occur in a cluster or series, and are more likely to include strange movements such as bicycling motions, screaming, or other activities.
How is it treated?
Frontal lobe seizures often can be well controlled with medications for partial seizures. If seizure medicines are not effective, vagus nerve stimulation or surgery may be help.
What's the outlook?
The outlook for people with frontal lobe epilepsy varies greatly, depending on the cause of the seizures. People with brain malformations or acquired lesions such as scar tissue caused by injury or infection are likely to require life-long treatment with seizure medicines. If the causes are genetic, the seizures eventually may stop.